Abstract:
BACKGROUND:Urgent colonoscopy is not always the preferred initial intervention in severe lower GI bleeding because of the need for a large volume of oral bowel preparation, the time required for administering the preparation, and concern regarding adequate visualization. OBJECTIVE:To evaluate the feasibility, safety, and outcomes of immediate unprepared hydroflush colonoscopy for severe lower GI bleeding. DESIGN:Prospective feasibility study of immediate colonoscopy after tap-water enema without oral bowel preparation, aided by water-jet pumps and mechanical suction devices in patients admitted to the intensive care unit with a primary diagnosis of severe lower GI bleeding. SETTING:Tertiary referral center. MAIN OUTCOME MEASUREMENTS:Primary outcome measurement was the percentage of colonoscopies in which the preparation permitted satisfactory evaluation of the entire length of the colon suspected to contain the source of bleeding. Secondary outcome measurements were visualization of a definite source of bleeding, length of hospital and intensive care unit (ICU) stays, rebleeding rates, and transfusion requirements. RESULTS:Thirteen procedures were performed in 12 patients. Complete colonoscopy to the cecum was performed in 9 of 13 patients (69.2%). However, endoscopic visualization was thought to be adequate for definitive or presumptive identification of the source of bleeding in all procedures, with no colonoscopy repeated because of inadequate preparation. A definite source of bleeding was identified in 5 of 13 procedures (38.5%). The median length of ICU stay was 1.5 days; of hospital stay, 4.3 days. Recurrent bleeding during the same hospitalization, requiring repeated endoscopy, surgery, or angiotherapy, was seen in 3 of 12 patients (25%). LIMITATIONS:Uncontrolled feasibility study of selected patients. CONCLUSION:Immediate unprepared hydroflush colonoscopy in patients with severe lower GI bleeding is feasible with the hydroflush technique.
journal_name
Gastrointest Endoscjournal_title
Gastrointestinal endoscopyauthors
Repaka A,Atkinson MR,Faulx AL,Isenberg GA,Cooper GS,Chak A,Wong RCdoi
10.1016/j.gie.2012.03.1391subject
Has Abstractpub_date
2012-08-01 00:00:00pages
367-73issue
2eissn
0016-5107issn
1097-6779pii
S0016-5107(12)01678-1journal_volume
76pub_type
临床试验,杂志文章abstract:BACKGROUND:Deep cannulation of the dorsal duct in patients with pancreas divisum may not be possible, even for the experienced endoscopist. This is a description of a technique to facilitate access to the dorsal duct. METHODS:Patients undergoing dorsal ductography in whom endoscopic therapy was indicated and in whom a...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1067/mge.2001.115474
更新日期:2001-07-01 00:00:00
abstract:BACKGROUND:Light-induced fluorescence endoscopy (LIFE) may improve the detection of high-grade dysplasia (HGD) and early stage cancer (EC) in Barrett's esophagus (BE). The aim of this study was to compare LIFE with standard endoscopy (SE) in a randomized crossover study. METHODS:Fifty patients with BE underwent SE and...
journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2005-05-01 00:00:00
abstract:BACKGROUND:Disposable biopsy forceps have been heavily marketed as cost-effective, convenient, and safer to use than conventional forceps. METHODS:In an attempt to define whether disposable or reusable biopsy forceps were cheaper to use, we prospectively evaluated the purchase price, number of uses, repair record, and...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(96)70252-3
更新日期:1996-01-01 00:00:00
abstract::Forty-six patients who underwent piecemeal resection of large, sessile villous adenomas followed by immediate laser photoablative therapy are presented. In contrast to previously published series utilizing laser alone, prior snare resection of such lesions provides copious tissue for histologic analysis, decreases the...
journal_title:Gastrointestinal endoscopy
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doi:10.1016/s0016-5107(89)72793-0
更新日期:1989-07-01 00:00:00
abstract:BACKGROUND:Colon capsule endoscopy (CCE) represents a noninvasive technology that allows visualization of the colon without requiring sedation and air insufflation. A second-generation colon capsule endoscopy system (PillCam Colon 2) (CCE-2) was developed to increase sensitivity for colorectal polyp detection compared ...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,多中心研究
doi:10.1016/j.gie.2011.03.1125
更新日期:2011-09-01 00:00:00
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journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2010.05.029
更新日期:2010-09-01 00:00:00
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journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:
更新日期:2003-09-01 00:00:00
abstract:BACKGROUND:Although early diagnosis of esophageal carcinoma is an important determinant of outcome, early stage carcinomas are rarely detected on routine endoscopic examination. Iodine staining may be useful in the detection of early stage esophageal carcinoma, especially in high-risk populations. In a prior study, 29....
journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章
doi:10.1067/mge.2001.111387
更新日期:2001-01-01 00:00:00
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journal_title:Gastrointestinal endoscopy
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更新日期:2007-08-01 00:00:00
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journal_title:Gastrointestinal endoscopy
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journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2012-09-01 00:00:00
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journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.gie.2012.03.007
更新日期:2012-07-01 00:00:00
abstract:BACKGROUND:Remote control of capsule endoscopes might allow reliable inspection of the human stomach. OBJECTIVE:To assess the safety and efficacy of manipulation of a modified capsule endoscope with magnetic material (magnetic maneuverable capsule [MMC]) in the human stomach by using a handheld external magnet. DESIG...
journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章
doi:10.1016/j.gie.2010.08.053
更新日期:2011-01-01 00:00:00
abstract::Biliary stent blockage by adherence of bacteria and formation of biofilm is a major problem in endoscopic stenting procedures. We have investigated bacterial adherence to hydrophilic polymer (Hydromer)-coated polyurethane stents in stationary and perfusion experiments. Adherence of gram negative and gram positive orga...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(93)70220-5
更新日期:1993-09-01 00:00:00
abstract:BACKGROUND:Use of colonoscopy is thought to reduce colorectal cancer (CRC) mortality, but its impact at the population level is unclear. OBJECTIVE:To estimate the effect of current colonoscopy use on CRC mortality and its further potential in reducing CRC mortality. DESIGN:Population-level analysis was performed by u...
journal_title:Gastrointestinal endoscopy
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更新日期:2011-03-01 00:00:00
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journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.gie.2010.01.057
更新日期:2010-07-01 00:00:00
abstract:BACKGROUND:Endoscopic insufflation has been associated with marked increase in intra-abdominal pressure (IAP) and hemodynamic and respiratory changes during transgastric surgery. OBJECTIVE:To investigate the hemodynamic and respiratory effects during intraperitoneal cavity exploration through 3 different natural orifi...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2011.10.015
更新日期:2012-08-01 00:00:00
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journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2008.05.015
更新日期:2009-04-01 00:00:00
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journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1991-09-01 00:00:00
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更新日期:2008-10-01 00:00:00
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更新日期:1995-03-01 00:00:00
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journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,多中心研究
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journal_title:Gastrointestinal endoscopy
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journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2005.07.051
更新日期:2006-01-01 00:00:00
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journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
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更新日期:2000-12-01 00:00:00
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journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
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journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
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journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
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更新日期:1988-01-01 00:00:00
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journal_title:Gastrointestinal endoscopy
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更新日期:2007-05-01 00:00:00